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Can a Benzo help with stress, agitation and restlessness


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I'm just wondering if a Benzo can help over the short term (few weeks / months maybe) for severe stress, agitation, restlessness, lack of sleep etc. 

 

I've been cycling through a load of different antidepressants lately in the hope of finding something that may help. The thing is I'm not totally convinced I am properly 'depressed', it is more I have chronic pain, long standing mental health issues and a load of family and life stress going on.  

 

On top of all that we have just discovered my step dad is sick and going to require major surgery (not for the first time in recent years)..... and basically I feel like I am bordering on going insane with worry/anxiety.   

 

I'm trying meditation, exercise, eating right but nothing is helping.   I really feel the need for something just to 'take the edge off' for a while, if that makes sense.  I'm wondering if it is even worth raising the subject of short term benzo or if that is completely inappropriate. I rarely drink but I tried a small drink last night just to try and relax a bit and that helped for about an hour but then obviously as it wore off I had even more difficulty sleeping. 

 

This is close to unbearable right now. 

 

 

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The short answer is Yes.

The more responsible answer is Yes but it would be far better to use it PRN as an adjunctive drug to back-up more effective long term medication.                                                                                                                                                                 

A TCA plus a AAP would probably give you much better balanced relief from anxiety and you might only have to use the benzo to cover acute episodes of panic.                                                                                       

Anxiolytics such as Buspirone  can give excellent relief and again use the benzo to top up.

Beta blockers, especially Propranolol, and old Antihistamines such as Hydroxyzine are also good possibilities.

 

Severe anxiety can cause incredible long term stress on the body and brain and result in a chronic feedback loop of pressure and anguish.     Benzos make poor solutions to long term anxiety (anything longer that 7 to 10 days) when used as a monotherapy.

Benzos do make excellent adjuntive drugs used PRN to back-up long term stabilizing medication.

Edited by glasssss999
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You and your doctor should have a conversation.   Setting up a date with a TDoc would be another excellent idea.  If your just looking for personal experiences I use a Benzo (As Needed / PRN) and it helps when things get really bad.  Its my opinion (Which is just mine - I have no medical degree) is to take care with all addictive drugs.  I'm pretty anal about them and use medhelp.org to chart when I use these types of drugs.  If your doctor is any good they will be on top of your use of them and being able to say how often you use them will tell her/him if its a good idea to prescribe them for you.

 

Buspar - helps me.  I've heard some people complain it either does nothing or that its hit or miss.   I like the fact that it doesn't have addiction baggage.  And unlike Benzos it doesn't make me feel sleepy or out of it.

 

TDocs can teach you CBT which is a good way to break up an anxiety attack.   Check that out first (I think)  The TDoc in my case was the one that said "I think you should talk to your doctor about medications"   I think I was showing some classic signs of depression.   And btw I've sense learned that the family secret  is that depression is common in my family.   *Not so secret since one of the cousins came out of the MI closet - Thank God!

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Yes, xanax and klonopin really help me. 

 

Also maybe a therapist would be helpful to talk to.

Yes I want a therapist........ I've seen one via my university (for free) who recommended I try and get longer term psychotherapy...... but it is very expensive to go privately and trying to get one via the health service is a massive problem.  I'm currently trying to complain and push as hard as possible for therapy as I do think it would benefit me a lot.  

 

I've had CBT in the past but it kinda glosses over the background issues.  I can no longer 'think positive' to feel better and the relaxation/mindfulness meditation I'm doing is not helping much either. 

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The short answer is Yes.

The more responsible answer is Yes but it would be far better to use it PRN as an adjunctive drug to back-up more effective long term medication.                                                                                                                                                                 

A TCA plus a AAP would probably give you much better balanced relief from anxiety and you might only have to use the benzo to cover acute episodes of panic.                                                                                       

Anxiolytics such as Buspirone  can give excellent relief and again use the benzo to top up.

Beta blockers, especially Propranolol, and old Antihistamines such as Hydroxyzine are also good possibilities.

 

Severe anxiety can cause incredible long term stress on the body and brain and result in a chronic feedback loop of pressure and anguish.     Benzos make poor solutions to long term anxiety (anything longer that 7 to 10 days) when used as a monotherapy.

Benzos do make excellent adjuntive drugs used PRN to back-up long term stabilizing medication.

Thanks for the reply. I do get the whole addiction thing - though I do believe I have strong will power/control and could manage the meds sensibly -  though I bet everyone thinks that, no one  wants to be an addict obviously. 

 

I've tried two TCAs now and they did not help - in fact one of them made me more agitated, as did celexa.   I have some very weird reaction to meds in general.

 

The thing is I'm not sure I would describe my problem as classic  anxiety either - it is more agitation.  Hard to make a distinction I know but it is this feeling of inner restlessness, racing thoughts, feeling angry/sad/frustrated all at the same time. The total inability to relax either physically or mentally.  However, it is NOT the classic  'racing heart, sweaty palms, dizzyness, panic, etc' you get with anxiety?  

 

It is not a panic or anxiety attack, it does not peak and go away in the same way, it is just a constant drone of feeling f***** all day start to finish. If you see what I mean.

 

Propranolol..... wow, blast from the past. :cool:   They gave me that as a child/teenager when my anxiety was so bad I refused to go to school.  never helped one bit...... plus has a reputation for making you depressed. 

 

atypical antipsychotics..... 1) they permanent side effects scare me. 2) no idea if my doc would prescribe them, suspect I would need a Pdoc, which is the same issue as above - getting to see one on the health service is v. difficult unless you are completely in crisis and a danger to yourself and or others. 

 

Currently toying with the idea of starting Moclobemide - a reversible MAOI, I hear it is good for anxiety (esp. social) but I also read that activation and insomnia are side effects - exactly what I don't need right now. 

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I took Klonopin for awhile but began to abuse it, and was subsequently taken off it.

 

It was fabulous for agitation.

 

But some people find benzos (as well as beta blockers) can worsen depression.

 

If you do want to try to obtain a script, make sure to let the provider know you have tried other remedies (SSRIs, exercise, meditation, diet) without success. Also mention life circumstances (e.g., family surgery) which are making you anxious at the moment.

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    Crazyguy  ...  You have just given a textbook description of chronic anxiety.            Some people (but not all) may have the physical symptoms  you desribe (but do not have) during acute panic attacks.  Not many people survive long with this type of stress. 

 

Most people with chronic anxiety live with the constant feelings of pressure cooker tension (physically and mentally) that you describe perfectly.     Mental agitation, hyper-alertness, every sense amplified,

lack of ability to concentrate or focus, exhaustion because you never let your guard down and relax.

 

There may be another issue to investigate here  ...  the possibility of ADHD.    The benzo might work in a partial way but it might be interesting to try ritalin or an equivalent.

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  • 5 weeks later...

Addiction is an illness, I don't even feel like looking up the "official" definition, since it was pinned in this forum several years ago, but no one finds it worth reading, and jump in with their assumptions as if they are medical fact.

 

Addiction and Dependency are different, you are dependent on almost every psych med you take. Would it be a good idea to get off of Lamictal cold turkey? How about insulin? Are all diabetics addicts?

 

So in fact, the short answer is maybe. The one obvious non-benzo treatment that I am not seeing is CBT. CBT is very useful for both short and long term bouts of anxiety. You can find a class, or you can work on it on your own using a widely used text, The Anxiety & Phobia Workbook, which you can buy in the crazystore. It could be I read too fast, and missed someone's suggesting it. But if you want to develop long term coping methods for anxiety and stress, CBT should be in your toolbox.

 

Buspar is hit and miss. There is a large population for whom it does nothing. When it works, it works well, but for everybody? Not even close.

 

Beta blockers are actually often used prn, if you are afraid you are an addict. However, they are not the most effective meds for anxiety, and often seem to work better for social anxiety: This is anecdotal, from what I have seen around here in the last 7 years, so I could be wrong. In either case it is not strong enough for a lot of peole

 

All the alternatives offered are based on the assumption that most people get addicted to benzos. That somehow, benzos are the only medication you can't stop cold turkey. And as I see over an over, dependence is being conflated with addiction.

 

Almost all drugs have a taper schedule, it is just that benzos schedule is much longer.

 

I took 1 mg/day of alprazolam for 6 months, and it took me 2 months to taper. I was easily able to follow the schedule, and did not crave it once it was gone. That was with a GP.

 

My pdoc after doing intake immediately put me on alprazolam 1mg bid with an extra mg prn. That was just over 7 years ago. That is still my prescription. I have so many prns floating around that my father (a pdoc) once accused me of hoarding for a suicide attempt. My pdoc encourages me to use the prn more than I do.

 

My husband has severe epilepsy, and takes 1mg clonezapam nightly. He also has a prescription for lorezepam, 2mg, prn for seizures.

 

He uses nowhere near that amount, and my pain Dr. and pdoc said I could use his ativan for killer headaches once or twice a month (I am on SSDI for migraine).

 

This is an important distinction that gets lost time and time again. It scares people who need them, and it stigmatizes people who use them. It is really ridiculous how often someone has had to define dependency vs. addiction in this forum.

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Most definitely! Klonopins for anxiety and irritability and restlessness and xanax for quick fast action against severe anxiety or panic attacks. Nothing comes close for me.

 

btw, just for the record, i took klons 1mg 3 times a day for about a year with lithium and stopped BOTH cold turkey on my own and experienced no withdrawal, Disclaimer: not everyone is the same. But I do not consider myself very special,

Edited by IndieVisible
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btw, just for the record, i took klons 1mg 3 times a day for about a year with lithium and stopped BOTH cold turkey on my own and experienced no withdrawal, Disclaimer: not everyone is the same. But I do not consider myself very special,

 

 

Stop it.  Stop encouraging people to go cold turkey off meds (or hard drugs for that matter).  I'm astonished you have no idea how potentially dangerous your words are (even with your little "disclaimers").

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The med that helped me most for agitation was seroquel. but that is an aap.

 

I do better with benzos taking a prescribed dose on a schedule.  Otherwise, I end up taking too much prn because I have lots of anxiety.  I don't take them anymore and I had little problem titrating off at my pdocs recommended 

 

I have the Anxiety and Phobia Workbook crtclms mentioned and I found it helpful.  CBT works great for anxiety and depression.  Some other books are Mind Over Mood or Feeling Good.

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  • 2 weeks later...

    Crazyguy  ...  You have just given a textbook description of chronic anxiety.            Some people (but not all) may have the physical symptoms  you desribe (but do not have) during acute panic attacks.  Not many people survive long with this type of stress. 

 

Most people with chronic anxiety live with the constant feelings of pressure cooker tension (physically and mentally) that you describe perfectly.     Mental agitation, hyper-alertness, every sense amplified,

lack of ability to concentrate or focus, exhaustion because you never let your guard down and relax.

 

There may be another issue to investigate here  ...  the possibility of ADHD.    The benzo might work in a partial way but it might be interesting to try ritalin or an equivalent.

Hi, thanks for that reply as it really backs up what I was thinking and what a couple of people in my 'real' life have said to me as well. I have these labels of depression, social anxiety and OCD but my basic problem is I worry constantly about everything and it is literally like being in a pressure cooker. 

 

So I thought I would update this thread.   I went on moclobemide which has helped in some areas; better concentration, energy and pain levels.  But it has not helped at all with the agitated feeling or the stress/restlessness and so on. 

 

To my surprise my doctor has suggested lorazepam..  I have major concerns about dependence and tolerance but I really need something to take the edge off right now so I think I will give it a go and see how I get on. 

Edited by crazyguy
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If you use it responsibly and as prescribed, it is unlikely you will have ill effects.

 

ETA: In my case we found that I was getting inadequate coverage from lorazepam because it was wearing off too fast and I was up to 6mg per day scheduled with 1-2 as needed mg. I didn't want to try klonipin because I had seen a lot of people get addicted to it. However, my care team and I found that when I was open to klonipin, it worked a LOT better because I had longer duration of coverage, and fewer anxiety spikes as the lorazepam wore off.

 

If I'm remembering right, I had something like 4 years of lorazepam total and 3 years of klonipin total. My dentist has STRONGLY suggested that I let her give me a prescription for valium before I come in to get any more dental work done. Heh.

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Xanax is the fastest acting and wears off the fastest too. That's what makes it so easy to build up a tolerance for which results in raising the dosage over time, which in turn makes it harder to weed off. Other benzo's like Klonopin and Valium take longer to go in to effect but they last longer which slows down our tolerance in time. I'm not sure where ativan falls I think it's fast like xanax. But I agree as long as you don't abuse and stay on the prescribed doses you should be fine. When it's time to take you off it your doc will know how to weed you off. BTW my doc was a little upset with me when I stopped everything cold turkey without discussing it with him first! I only mentioned it earlier because it does not always have to be as bad as some of the horror stories we hear about. Of course I would never advocate stopping cold turkey on any med before discussing it with a doc. Good luck and keep us updated!

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Xanax is the fastest acting and wears off the fastest too. That's what makes it so easy to build up a tolerance for which results in raising the dosage over time, which in turn makes it harder to weed off. Other benzo's like Klonopin and Valium take longer to go in to effect but they last longer which slows down our tolerance in time. I'm not sure where ativan falls I think it's fast like xanax. But I agree as long as you don't abuse and stay on the prescribed doses you should be fine. When it's time to take you off it your doc will know how to weed you off. BTW my doc was a little upset with me when I stopped everything cold turkey without discussing it with him first! I only mentioned it earlier because it does not always have to be as bad as some of the horror stories we hear about. Of course I would never advocate stopping cold turkey on any med before discussing it with a doc. Good luck and keep us updated!

Well I took 2 pills today (morning and afternoon) to help with anxiety and didn't notice anything apart from feeling spaced out.  I was still very anxious and on top of that I got paranoid that people could tell I was 'on something'.

I don't know if I should take the medication regularly to see if it builds up in the body the same way an antidepressant does?   Given all the hype around benzos (very black or what views around the internet) maybe I was expecting too much.

 

Or should I go back to the DR and ask for maybe a different type of benzo (reading up on this and it appears they are a large family of drugs to choose from?).  

Edited by crazyguy
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